Does the use of a resident’s body for purposes of training by emergency medical personnel without informed consent from the resident prior to death or consent from their responsible party/family after their death constitute abuse and a violation of that resident’s right to privacy under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the right to respect and dignity?
Compliance Perspective – Deceased Resident
Policies and Procedures: The Compliance and Ethics Officer with the Privacy Officer, the DON and the Administrator will review the facility’s policies and procedures regarding a deceased resident’s right to privacy under HIPAA and the right to dignity, respect and self-determination (F557, F561) and the use of advance healthcare directives. Education and Training: Admissions staff will be educated about the importance of obtaining advance directives from residents being admitted to the facility or their designated party. Staff will be educated and trained on following a resident’s advance health directives or directives from their designated responsible party. Staff should be made aware that they are responsible for ensuring that those directives are made known to entities that may be called upon to provide care, e.g., EMTs and paramedics. Auditing: An audit will be conducted to determine if residents have advance directives on file, if staff are aware of those directives, and whether they are entered into the resident’s records and the facility’s computer system. The audit should determine the extent that this information is being shared with emergency personnel when called to be involved in a resident’s care. Completed audits will be summarized and submitted to the QAPI/QAA Committee for review and recommendations.
The Washington State Health Department has begun an investigation into an incident involving a deceased resident of a nursing home where firefighter paramedics, EMTs, and some office workers used the resident’s body for their training on intubation.
An investigation by the city found that 11 employees were involved in 15 attempts to perform endotracheal intubations on the deceased resident’s body. The firefighters brought the deceased resident’s body to the fire station after the hospital refused to accept it. The funeral home was contacted but indicated it would not arrive to pick up the deceased resident for 45 minutes.
The city’s Fire Chief condemned the incident as being terrible and unacceptable and reported that the two top-ranking employees involved resigned and everyone involved received some sort of discipline. That discipline ranged from being suspended without pay to having letters placed in their personnel files.
Although reporters contacted other EMS providers, none of them indicated that they allow intubations on deceased individuals for training purposes.
The city’s investigation did discover that over the last 25 years some paramedics have used deceased patients to fulfill their license recertification requirements for intubation.
County officials indicated that paramedics are required to complete 12 intubations each year to retain their licenses. However, they are supposed to perform them on living patients. When necessary, arrangements are made with a hospital to allow paramedics to perform the intubations on patients who need to have it done.
The city’s Fire Chief reported that the training policy for city firefighters is being reviewed along with the issue of where to take a deceased person’s body when they die in a medic unit.
